Active NPI
Ibiyemi Donald Fabanwo, B.A
- Mental Health Counselor
- Forest Hills, NY
National Provider Identifier
1942443858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 10205 63Rd Rd
Forest Hills, NY 11375-1048 - Phone
- (347) 426-1190
- NPI assigned
- Apr 8, 2009
- Last updated
- Apr 8, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NU | Primary |
Addresses
Primary practice location
10205 63Rd Rd
Forest Hills, NY 11375-1048
Mailing address
40 Rector St FL 8
New York, NY 10006-1733
Phone (212) 385-3030
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Institute for Community Living , Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Brooklyn, NY
- NPI 1558494930
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239148800000",
"number": "1942443858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 RECTOR ST FL 8",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100061733",
"telephone_number": "212-385-3030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10205 63RD RD",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113751048",
"telephone_number": "347-426-1190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FABANWO",
"first_name": "IBIYEMI",
"middle_name": "DONALD",
"name_prefix": "Mr.",
"credential": "B.A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-08",
"last_updated": "2009-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.